Cold urticaria in the doctor’s practice

Objective — to improve the methods of differential diagnosis and management of patients with cold urticaria. Materials and methods. A review of the literature is presented and diagnostic approaches and principles of management of patients with cold urticaria are analyzed. Results and discussion. Cold urticaria is characterized by itching, angioneurotic edema, or both, with or without anaphylaxis which occurs in response to cooling of the skin and/or mucous membranes. The incidence of cold urticaria is estimated at 0.05 %, with higher rates in cold climates. It is believed that the symptoms of urticaria are primarily related to the activation of mast cells in the skin. However, in recent years, data have emerged highlighting the possible role of blood coagulation in the pathophysiology of the disease. In some patients, in parallel with the development of cold urticaria in response to cold factors, especially cold air, there may be reactions that are clinically similar to sinusitis, conjunctivitis and bronchial asthma, although it may coexist with other types of urticaria. The main principles of treatment of patients with urticaria are: identification of causative factors, education of patients and prevention of contact with causative factors, and stepwise pharmacotherapy. Conclusions. Cold urticaria is a subtype of chronic induced urticaria that has all the features of this heterogeneous group of diseases, but is still poorly understood in terms of both pathogenesis and real epidemiology. Elimination measures, patient education and treatment according to existing algorithms can significantly improve the quality of life of patients, which is a priority for the treatment of any chronic disease.